Tourette syndrome and tic disorders cause uncontrollable movements or sounds called tics. Tourette syndrome, a neurological disorder, often appears in early childhood and usually improves as the child gets older.

Tics can be vocal or motor and range from mild to severe. Treatment plans may include medications, therapies and specialized care that help to reduce the symptoms of tics.

What are Tourette syndrome and tic disorders?

Tourette syndrome (TS) and tic disorders are movement disorders caused by abnormailities in the brain and nerves. Tourette syndrome, a severe type of tic disorder, causes a person to make sudden, uncontrollable movements or sounds.

Tics are involuntary and usually cannot be controlled or prevented by the person with Tourette syndrome and tic disorders.

There are two types of tics: motor and vocal. Examples of a motor tic include body movements like shoulder shrugging or excessive blinking, while a vocal tic includes use of the voice like yelling or throat clearing.

Tics may occur many times a day and tend to improve or to get worse during stressful times in life (stress, anxiety, sleep deprivation). Tics also commonly may change over time.

How common is Tourette Syndrome?

About 350,000 people in the United States have the severe form of a tic disorder - Tourette syndrome. Tourette syndrome usually develops in early childhood, between ages five and seven, and often improves as a child becomes an adult.

What are the symptoms of Tourette Syndrome and tic disorders?

Tic disorders can be mild or severe. When symptoms are mild, parents and caregivers may overlook a child's tics.

When the symptoms are more severe, Tourette syndrome is typically diagnosed. The main symptom of Tourette is severe tics that usually start between ages five and seven.

Tics can be considered complex or simple tics. Examples of a complex tic include many movements and muscle groups such as jumping, while a simple tic involves quick, repeated movements such as shoulder shrugging. The symptoms of Tourette syndrome or a tic disorder are broken into motor tics or vocal tics.

Symptoms of a motor tic include:

• Arm jerking
• Bending at the waist
• Copropraxia (obscene gestures)
• Eye blinking
• Head jerking or twisting
• Hopping
• Jaw movements
• Jumping
• Kicking
• Twisted or distorted facial expressions

Symptoms of a vocal tic include:

• Barking
• Coprolalia (obscene words or remarks; actually an uncommon manifestation)
• Grunting
• Shouting
• Sniffing
• Throat clearing

Diagnosis of a related disorder is also common. About 5 in 6 children with Tourette syndrome are commonly diagnosed with at least one mental health, behavioral or developmental disorder.

Related disorders include attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD) or symptoms, impulse control disorder or symptoms, anxiety and/or depression.

How are Tourette Syndrome and tic disorders diagnosed?

Your UF Health neurology care team can diagnose a tic disorder during your patient visit.

Blood tests and imaging exams cannot be used to make a diagnosis a tic disorder, but your care team will review your medical history and symptoms and ask detailed questions about your tic symptoms, including:

• How often does your tic happen?
• At what age did your tic start?
• Is your tic simple or complex?
• Is your tic motor or vocal?

Your care team may also order tests to rule out other conditions that could be causing tics.

To be diagnosed with Tourette syndrome, your tics must have started before the age of 18. For your tic disorder to be considered Tourette syndrome, you must have experienced both motor tics and vocal tics consistently for more than a year.

How are Tourette Syndrome and tic disorders treated?

Children who have mild symptoms or a simple tic frequently do not require treatment beyond education as side effects from medications may be worse than the symptoms of Tourette syndrome.

For complex tic disorders, treatment options are available through the use of medications and therapy. Your UF Health care team will determine the best treatment plan for your tic severity.

Treatment options could include:

• Comprehensive behavioral intervention therapy (CBIT)
• Medications (i.e., Haloperidol (Haldol), pimozide (Orap), and aripiprazole (Abilify), etc.)
• Deep brain stimulation (DBS) surgery